Not a member of Pastebin yet?
Sign Up,
it unlocks many cool features!
- <!DOCTYPE html>
- <html>
- <head>
- <title></title>
- </head>
- <body>
- <table align='center' border='1' width='700' height='980' bgcolor='' >
- <tr>
- <td>
- <br>
- <dir style='background-color:while;'>
- <p align='center'>
- <font color='000000' size='4'>--PLEASE INPUT YOURE DATA-- </font>
- </dir>
- <form name='formjob' action='jobprint_pre.php' method='post' enctype='mutipart/form-data' >
- Name<input type='text' name='firstname' size='20' value='' ></input>
- LastName<input type='text' name='Lastname' size='20' value='' ></input>
- <p>
- Gender Female <input type='radio' name='gender' size='25' value='female' ></input>
- Male<input type='radio' name='gender' size='25' value='male' ></input>
- </p>
- <p> Birthdate Data
- <?php
- echo "<select name='slectdate'>";
- for ($i=0; $i <=31 ; $i++)
- echo"<option value='$i'>$i</option>";
- echo "</select>";
- echo "<select name='selectmounth'>";
- $m=array('January','Febuary','March','April','May','June','July','Agust','September','October','November','December');
- for ($i=0; $i < 12; $i++)
- echo"<option value='$m[$i]'>$m[$i]</option>";
- echo "</slect>";
- ?>
- Year<input type="text" name="year" size='10' value="">(value>1950)</p></input>
- <p> Addresss <input type='text' name='address' size='60' value=''> </input></p>
- <p> Telephon Number <input type='text' name='phon' size='20' value=''> </input></p>
- <p> homepage <input type='text' name='homepage' size='40' value=''> </input></p>
- <p>Education</p>
- <p> <input type='radio' name='education' value='Secondary Education'>
- Secondary Education
- </p>
- <p> <input type='radio' name='education' value='Dregree'>
- Bachelor Degree
- </p>
- <p> <input type='radio' name='education' value='Master'>
- Master degree
- </p>
- <p>Position</p>
- <p> <input type='cheakbox' name='postion1' value='Office admninistrator'>Office admninistrator</p>
- <p> <input type='cheakbox' name='postion2' value='acctountant'>acctountant</p>
- <p> <input type='cheakbox' name='postion3' value='customer support webdesigner'>
- customer support webdesigner</p>
- <p> <input type='cheakbox' name='postion4' value='programer'>programer</p>
- <p> <input type='cheakbox' name='postion4' value='System Engineer'>System Engineer</p>
- <p>Salary<input type='text' name='salary' size='15' value='15'>bath</input></p>
- <p>Picture<input type='file' name='picture' size='15' value='50'>bath</input></p>
- <input type='hidden' name='MAX_FILE_SIZE'value='10000'></input>
- <p>Experience</p>
- <p><textarea name='work' rows='100' cols='60'></textarea></p>
- <input type='submit' name='submit' value='Submit now'> </input>
- <input type='reset' value='Click to Reset'> </input>
- </form>
- </td>
- </tr>
- </table>
- </body>
- </html>
Advertisement
Add Comment
Please, Sign In to add comment